- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.67 / $315.67 / $2,168.00
| Facility | | $315.67 | $315.67 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $265.49 / $2,783.41
| Facility | | $0.98 | $265.49 | $2,783.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.64 / $1,097.69 / $2,640.63
| Facility | | $773.64 | $1,097.69 | $2,640.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.31 / $1,003.55 / $2,079.23
| Facility | | $703.31 | $1,003.55 | $2,079.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.84 / $538.70 / $897.84
| Facility | | $329.84 | $538.70 | $897.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |